簡易人壽保險詢問告知與謹慎核保原則之研究

A Study on the Inquiry-Disclosure and Prudent Underwriting Principles of Simple Life Insurance

林昭志(Chao-Chih Lin)

《高大法學論叢》 12卷1期 (2016/09) Pp. 213-285+287-297

摘要

簡易壽險在詢問告知原則的運作下，保險人應將影響危險估計事項列於要保書之詢問中，告知義務人只需針對該詢問作回覆，其告知義務即告履行。蓋簡易壽險乃為社會大眾所設計的險種，一般民眾對於何謂「足以變更或減少保險人對於危險之估計者」普遍缺乏認知，故於要保書未為詢問之事項，應視為不影響保險人對危險之估計，如此解釋，始能保障簡易壽險消費者之權益。隨著保險法制發展，謹慎核保原則已逐漸受到重視。因此，簡易壽險之保險人應於締結契約前對要保人履行三種義務，依序是：適合度評估義務、資訊說明與風險揭露義務，以及適當調查義務。目前我國簡易人壽保險法對於詢問告知的規範，仍有缺失存在；另一方面，謹慎核保原則下課以保險人義務的法律規範，亦尚未明確。本文提出疑義並以加以討論，對所提及之議題，必然於文中加以釐清。

關鍵字

簡易人壽保險 ； 最大誠信原則 ； 契約前 ； 詢問告知 ； 謹慎核保 ； 金融消費者保護法

並列摘要

Practicing the inquiry-disclosure principle, the simple life insurer should have the inquiries which would influence the risk assessment listed in the proposal form. Having responded those inquiries, the duty of disclosure obligor comes to be carried out. Basically, designed for the general public, the simple life insurance consumers commonly have lack of knowledge on what ＂sufficient to alter or diminish the insurer' estimation of the risk to be undertaken＂ is. For the sake of the interests of the consumers, it should be regarded as having no influence on the insurer's estimation of the risk whatever matters have not showed on the inquiry of the proposal form. Following the development of insurance law, the principle of prudent underwriting has begun to be paid much attention. Prior to the contracting stage, the simplified life insurer is imposed on fulfilling three sorts of duties, duty to assess the suitability, duty to explain and disclose the information, and duty to appropriately investigate. Back to the Taiwan's legal system, there are several deficiencies in the he inquiry-disclosure provision provided by the Simple Life Insurance Act; moreover, the principle of prudent underwriting codified into the current statutes is still insufficient. This paper is going to solve the doubts and draw suggestions. For each paragraph, after the points at issue have been stated, a potential solution will be proposed.

並列關鍵字

simplified life insurance ； principle of utmost good faith ； pre-contract ； inquiry-disclosure ； prudent underwriting ； Financial Consumer Protection Act

參考文獻

江朝國(2015)。保險法逐條釋義。台北=Taipei:元照=Angle。

吳玉鳳(2013)。保險人之諮詢建議—兼評高雄地院九十七年保險簡上字第四號判決締約上過失。全國律師。17(4)，86-106。

何思湘（2010），《保險法第64 條有關據實說明義務之研究》，載於立法院全球資訊網http://www.ly.gov.tw/05_orglaw/search/lawView.action?no=11458（最後瀏覽日：11/ 11/ 2015）。Ssu-Hsiang He (2010). A Study on the Duty to Make Truthful Representations Stipulated in the Article 64 of the Insurance Act, Retrieved Nov. 11, 2015, from the website of Conference & Gazette Management System, Legislative Yuan: http://www.ly.gov.tw/05_orglaw/search/lawView.action?no=11458.

杜怡靜(2010)。投資型保險商品關於說明義務與適合性原則之運用－台北地院九十六年度保險簡上字第六號及台北地院九十七年度再易字第一號判決。月旦民商法雜誌。27，130-141。

林昭志、陳冠甫(2013)。論誠實信用原則之具體化適用—以權利失效、棄權與禁止反言為中心。財產法暨經濟法。35，71-107。